Cloth Masks and Sanitizer - Request Form * We are partnering with Isanti County Emergency Management to distribute cloth masks and liquid hand sanitizer to our area businesses. Please complete this form to request these supplies for use at your business/organization. We will contact you via email after Tuesday, February 16, 2021 with information about when you can pick up these items from our office. Questions can be directed to info@north65chamber.com. Thank you! Company Name * Industry * Address Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Contact Person First Name * Last Name * Phone Number * Email address * Number of Employees * Include full and part time. Average Daily Customer Count * Estimate to the best of your ability. Number of Cloth Masks Requested (available in units of 5) * 5 10 15 20 25 I could use more than 25 Number of Hand Sanitizers Requested (approx. 8oz each, limited supply) * Don't need any Need a few Have a large need